oppCDC-RFA-GH18-1804-cfda93.185-cidCDC-RFA-GH18-1804-instructions.pdf

Centers for Disease Control

Center for Global Health

Support for Activities to Eradicate Polio, Accelerate Control of Measles and Rubella with

United Nations Children's Fund (UNICEF)

CDC-RFA-GH18-1804

Application Due Date: 05/09/2018

Support for Activities to Eradicate Polio, Accelerate Control of Measles and Rubella with

United Nations Children's Fund (UNICEF)

CDC-RFA-GH18-1804

TABLE OF CONTENTS

Part I. Overview Information A. Federal Agency Name B. Funding Opportunity Title C. Announcement Type D. Agency Funding Opportunity Number E. Catalog of Federal Domestic Assistance (CFDA) Number F. Dates G. Executive Summary

Part II. Full Text A. Funding Opportunity Description B. Award Information C. Eligibility Information D. Application and Submission Information E. Review and Selection Process F. Award Administration Information G. Agency Contacts H. Other Information I. Glossary

Part I. Overview Information Applicants must go to the synopsis page of this announcement at www.grants.gov and click on the "Send Me Change Notifications Emails" link to ensure they receive notifications of any changes to CDC-RFA-GH18-1804. Applicants also must provide an e-mail address to www.grants.gov to receive notifications of changes.

A. Federal Agency Name:

Centers for Disease Control and Prevention (CDC) / Agency for Toxic Substances and Disease Registry (ATSDR) B. Notice of Funding Opportunity (NOFO) Title:

Support for Activities to Eradicate Polio, Accelerate Control of Measles and Rubella with United Nations Children's Fund (UNICEF) C. Announcement Type: New - Type 1 This announcement is only for non-research activities supported by CDC. If research is proposed, the application will not be considered. For this purpose, research is defined at https ://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf.

Guidance on how CDC interprets the definition of research in the context of public health can be found at https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html (See section 45 CFR 46.102(d)).

D. Agency Notice of Funding Opportunity Number:

CDC-RFA-GH18-1804

E. Catalog of Federal Domestic Assistance (CFDA) Number:

93.185 F. Dates:

1. Due Date for Letter of Intent (LOI): N/A

2. Due Date for Applications: 05/09/2018, 11:59 p.m. U.S. Eastern

Standard Time, at www.grants.gov.

3. Date for Informational Conference Call:

N/A

G. Executive Summary:

1. Summary Paragraph:

This agreement provides resources to the recipient to support polio eradication, maternal and neonatal tetanus elimination, and regional measles and rubella elimination; planning and implementation of, and demand for, supplemental immunization campaigns; and strengthening of routine immunization delivery systems and capacity in developing countries. These functions are critical to achieving globally agreed goals for VPD elimination and reduction. This agreement also may support activities to address other global health priorities in line with CDC goals.

Results and measurable outcomes must align with Government Performance Results Act (GPRA) objectives: Long Term Objective 10.B.1: Help domestic and international partners achieve WHO's goal of global polio eradication; or Long Term Objective 10.B.2: Help domestic https://www.grants.gov https://www.grants.gov https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html https://www.grants.gov and international partners to eliminate maternal and neonatal tetanus by 2020; Work with global partners to reduce global measles-related mortality by 90% compared with 2000 estimates (777,000 deaths), assist in the achievement of the GVAP 2020 goals of elimination of measles and rubella in 5 WHO regions and to maintain elimination of endemic measles and rubella virus transmission in all 47 countries of the Americas.

This a non-research announcement. If research is proposed, the application will not be reviewed. For the definition of research, see: http://www.cdc.gov/od/science/integrity/docs/cdc-policy-distinguishing-public-health-research-nonresearch.pdf

a. Eligible Applicants: Single

b. NOFO Type: Cooperative Agreement

c. Approximate Number of Awards: 1

d. Total Period of Performance Funding: $0 There is not project period ceiling; however, the estimated amount is $180,000,000

e. Average One Year Award Amount: $36,000,000

f. Total Period of Performance Length: 5

g. Estimated Award Date: 07/01/2018

h. Cost Sharing and / or Matching Requirements: N Cost sharing or matching funds are not required for this program. Although no statutory matching requirement for this NOFO exists, leveraging other resources and related ongoing efforts to promote sustainability is strongly encouraged.

Part II. Full Text A. Funding Opportunity Description

Part II. Full Text

1. Background

a. Overview The U.S. Congress provides funds to CDC for programmatic support to sustain and strengthen essential global, regional, and national immunization program capacity needed to control, eliminate and eradicate vaccine-preventable diseases (VPDs). The success of the Global Polio Eradication Initiative has brought the world to the cusp of eradicating polio. Maternal and Neonatal tetanus have been eliminated in all but 16 countries and the number of neonatal deaths due to tetanus decreased from over 700,000 in 1988 to 34,000 in 2015. Estimated global measles deaths decreased by 79% from 546,000 in 2000 to 114,900 in 2014; along with decreases in pneumonia and diarrhea, the decline in measles deaths is among the three main contributors to the decline in overall child mortality during this time period. Use of new and underutilized vaccines and continued use of measles vaccine is estimated to save 23.3 million lives from 2011 to 2020 in low income countries. However, more work is needed to achieve the unfinished global immunization agenda highlighted in the Global Vaccine Action Plan, 2011-http://www.cdc.gov/od/science/integrity/docs/cdc-policy-distinguishing-public-health-research-nonresearch.pdf http://www.cdc.gov/od/science/integrity/docs/cdc-policy-distinguishing-public-health-research-nonresearch.pdf

2020 (GVAP) to prevent the 15% to 22% of child deaths globally that are vaccine-preventable.

Additionally, more work needs to be done on the achievement of the GVAP 2020 goals of elimination of measles and rubella in 5 WHO regions. Polio, measles, and rubella/CRS have been successfully eliminated from the Western Hemisphere, and other once common infections such as diphtheria, tetanus, pertussis, meningococcus, pneumococcus, Haemophilus influenzae type b and rotavirus rarely occur in the United States. However, Americans remain at risk for VPDs as long as they persist anywhere in the world.

The purpose of this cooperative agreement is to support the recipient in collaboration with partners to sustain and strengthen global, regional, and national immunization program capacity needed to:

Achieve the globally agreed-upon goals of GVAP (including polio eradication, elimination targets for measles, rubella, and neonatal tetanus, and national and subnational vaccination coverage targets)

Achieve the 2030 Sustainable Development Goal (SDG) target to end vaccine-preventable deaths of children under 5 years of age

Reduce chronic disease and cancer deaths from VPDs Prevent, detect, and respond to VPD outbreaks

To achieve these targets, high quality country-led national immunization program capacity, linked to strong health systems, is needed to provide vaccination services, integrated laboratory and epidemiological disease surveillance, and immunization information systems. In addition, global and regional immunization program capacity is needed both to sustain and strengthen high quality country-led immunization programs, and to prevent, detect and respond to VPD outbreaks that cross borders.

A key step to build and strengthen immunization program capacity is to use strategically the strengths and complementarity of both health system strengthening efforts and disease-specific efforts. Disease-specific efforts depend on strong immunization programs as an integral part of a well-functioning health system, and targeted health system strengthening efforts can be guided and strengthened by capacity needed to achieve disease-specific targets. In particular, this cooperative agreement will focus on developing and implementing a tactical approach to reach both the national and subnational vaccination coverage targets, and the measles and rubella elimination targets, as committed to in the GVAP.

b. Statutory Authorities Sections 301 (c), 307, and 317 of the Public Health Service Act (42 U.S.C. sections 242l (c), and 247b); and section 104 of the Foreign Assistance Act of 1961 (22 U.S.C. 2151b)

c. Healthy People 2020 This program addresses the “Healthy People 2020” focus area(s) of Immunization and Infectious Disease, and Maternal, Infant and Child Health. https://www.healthypeople.gov /2020/topics-objectives/topic/immunization-and-infectious-diseases

d. Other National Public Health Priorities and Strategies This NOFO will support the US Government endorsed Global Polio Eradication Initiative http://www.healthypeople.gov/ http://www.healthypeople.gov/

(GPEI) and the Global Vaccine Action Plan, 2011-2020 (GVAP). http://polioeradication.org /who-we-are/governance/polio-oversight-board/.

In addition, this NOFO will support CDC’s Global Health Strategy, http://www.cdc.gov/globa lhealth/security/index.htm.

e. Relevant Work Agency Notice of Funding Opportunity Number: CDC-RFA-GH13-1302, Cooperative Agreement on Immunization with the United Nations Children’s Fund (UNICEF), is the previous NOFO between CDC and the recipient. This NOFO builds on the activities and goals of CDC-RFA-GH13-1302 by continuing work on polio eradication, measles elimination and other VPD activities.

2. CDC Project Description

a. Approach

Bold indicates period of performance outcome.

Strategies and Activities Short-term Outcomes Intermediate

Outcomes Long-Term Outcomes

· Assist member countries in achieving Immunization goals, including polio eradication, measles, rubella/CRS, maternal and neonatal tetanus elimination, Hepatitis B control and routine immunization

· Lead development of and support the scientific innovation and evaluation needed to guide development of global immunization policies, standards and tools for vaccine management and logistics and social mobilization and vaccine demand creation

· Work with partners to assist Ministries of Health with development of guidelines and multiyear

· Increased polio vaccine delivery to endemic countries

· Increased capacity to generate, interpret and use surveillance data

· Increased use of evidence-based immunization policy and program decision making

· Improved social mobilization, advocacy and communication

· Increase in systematic efforts to assess demand barriers for routine immunization and tailor community engagement strategies to local conditions and appropriate platforms

· Increase in country

· Global interruption of wild poliovirus and vaccine-derived poliovirus transmission

· All regions will have rubella elimination goals.

· Countries will have introduced MCV2, achieved high quality SIAs, established CRS surveillance and high quality Measles-rubella and tetanus surveillance.

· Improved rapid detection and response of VPD outbreaks

· Increased use of evidence by regions and countries to improve immunization policy and practices

· Measles and rubella/CRS and neonatal tetanus eliminated globally

· All regions reach their hepatitis B control goals

· Incidence of other VPDs is measurably decreased

· Increased vaccine equity and coverage

· Strong resilient national immunization programs self-sustaining with country resources

· Improved and sustained support for vaccine delivery http://polioeradication.org/who-we-are/governance/polio-oversight-board/ http://polioeradication.org/who-we-are/governance/polio-oversight-board/ http://www.cdc.gov/globalhealth/security/index.htm http://www.cdc.gov/globalhealth/security/index.htm plans for immunization which address all aspects of immunization systems

· Work with partners to assist countries in the development and implementation of workforce training and other performance improvement strategies

· Provide vaccines and logistical and technical support to implement delivery of safe and effective vaccines

· Work with partners to assist the monitoring and evaluation of all aspects of the immunization system.

· Generate economic and financial evidence to support sustainable immunization financing, program planning, budgeting and decision making

· Work with partners globally, regionally and nationally to develop polio transition strategies.

capacity for vaccine safety assessment and response

· Improved ability to monitor sub-national program performance and identification of inequities

· Measurable increase in country capacity to support vaccine introduction

· Improved technical and management capacity, performance and accountability of the immunization workforce

· Improved quality and increased use of Immunzation Information Systems data to monitor, evaluate, and improve immunization programs

· Improved knowledge and use of economic and financing information among immunization stakeholders

· Increased number of countries with Polio transition strategies officially documented

· Improved and maintained vaccine coverage and equity

· Sustained support for immunization and VPD surveillance institutions policies and practices

· Polio assets and resources transitioned to other immunization activities

· High functioning adequately resourced and trained national immunization workforces

· Increase in demand for both routine and campaign immunization services and decrease in vaccine hesitancy

· Increased country ownership of immunization programs

· Enhanced performance of immunization programs is achieved

i. Purpose The Notice of Funding Opportunity is to sustain support for the US Government-endorsed Global Polio Eradication Initiative, Measles and Rubella Initiative, Global Vaccine Action Plan and the CDC’s Global Immunization Strategic Framework, 2016-2020. This agreement provides resources to the recipient to strengthen routine immunization systems, enhance global strategies to measure and respond to threats to vaccine demand, and conduct supplemental immunization campaigns, in low to middle income countries. All are critical to achieving globally agreed goals for disease elimination and reduction.

ii. Outcomes Short-term Outcomes

Increased polio vaccine delivery to endemic countries Increased capacity to generate, interpret and use surveillance data Increased use of evidence-based immunization policy and program decision making Improved social mobilization, advocacy and communication Increase in systematic efforts to assess demand barriers for routine immunization and tailor community engagement strategies to local conditions and appropriate platforms Increase in country capacity for vaccine safety assessment and response Improved ability to monitor sub-national program performance and identification of inequities Measurable increase in country capacity to support vaccine introduction Improved technical and management capacity, performance and accountability of the immunization workforce Improved quality and increased use of Immunization Information Systems data to monitor, evaluate, and improve immunization programs Improved knowledge and use of economic and financing information among immunization stakeholders Increased number of countries with polio transition strategies officially documented

Intermediate outcomes

All regions will have rubella elimination goals.

Improved and maintained vaccine coverage and equity Polio assets and resources transitioned to other immunization activities Increase in demand for both routine and campaign immunization services and decrease in vaccine hesitancy

Long-term outcomes

All regions reach their hepatitis B control goals Increased vaccine equity and coverage Improved and sustained support for vaccine delivery

iii. Strategies and Activities

Assist member countries in achieving immunization goals, including polio eradication, measles, rubella/CRS, maternal and neonatal tetanus elimination, Hepatitis B control and routine immunization coverage targets

Lead development of and support the scientific innovation and evaluation needed to guide development of global immunization policies, standards and tools for vaccine management and logistics and social mobilization and vaccine demand creation Work with partners to assist Ministries of Health with development of guidelines and multiyear plans for immunization which address all aspects of immunization systems Work with partners to assist countries in the development and implementation of workforce training and other performance improvement strategies Provide vaccines and logistical and technical support to implement delivery of safe and effective vaccines Work with partners to assist the monitoring and evaluation of all aspects of the immunization system.

Generate economic and financial evidence to support sustainable immunization financing, program planning, budgeting and decision making Work with partners globally, regionally and nationally to develop polio transition strategies.

1. Collaborations

a. With other CDC programs and CDC-funded organizations:

Collaborate with CDC, World Health Organization (WHO), other partner agencies including BMGF, USAID, Rotary, Gavi and others as well as national governments, for implementation of strategies to achieve the globally agreed goals of polio eradication, maternal and neonatal tetanus elimination, and measles and rubella elimination, and control of other vaccine preventable diseases (VPD), including identification and prioritization of country vaccine and programmatic assistance needs. The recipient will allocate funding for procurement of vaccines and to provide technical assistance in collaboration with CDC and WHO.

b. With organizations not funded by CDC:

Collaborate with Rotary International, other partner agencies and national governments, for implementation of strategies to achieve the globally agreed goals of polio eradication, maternal and neonatal tetanus elimination, measles and rubella elimination, and control of other vaccine preventable diseases (VPD), including identification and prioritization of country vaccine and programmatic assistance needs. The recipient will allocate funding for procurement of vaccines and to provide technical assistance in collaboration with CDC and WHO.

2. Target Populations The main target population will be determined based on published immunization guidelines for specific VPDs. Applicants should describe how the program will reach populations of specific concern including but not limited to:

* Underserved and hard to reach populations in resource-limited countries;

* Children under 5 years;

* Mothers and pregnant women

a. Health Disparities This NOFO supports GIDs efforts to improve the health of populations disproportionately affected by VPDs by maximizing the health impact of immunization services, reducing disease prevalence, and promoting health equity by reducing or eliminating systematic disparities in health and healthcare systems and services. Health equity is a desirable goal that entails special efforts to improve the health of those who have experienced social or economic disadvantage.

Programs should use data to identify populations within their jurisdictions that are disproportionately affected by VPDs and develop plans to eliminate health disparities.

Applicants should strive to include:

* rural populations;

* non-English speaking populations;

* transient or nomadic populations;

* people with limited health literacy;

* other vulnerable groups.

Additionally, CDC’s Strategic Framework for Global Immunization, 2016-2020, aims to reduce and eliminate Health Disparities through equitable access to and utilization of vaccines.

Applicants must outline how they will develop program strategies focused on strengthening national vaccination delivery platforms for populations across the life-span, such as pregnant women, children in the first and second years of life, children at school-entry, and older children and adolescents.

iv. Funding Strategy N/A

b. Evaluation and Performance Measurement

i. CDC Evaluation and Performance Measurement Strategy The purpose of evaluation and performance measurement is to help CDC recipients: (1) Monitor the extent to which activities were successfully completed; (2) Demonstrate progress toward achieving program outcomes (e.g., Were outcomes of interest achieved?); and (3) Inform decisions about future programming that drive continuous program improvement for more efficient and effective program performance (e.g., What and how could things be improved?).

An Evaluation and Performance Measurement Plan (EPMP) is required as part of this NOFO to measure NOFO accomplishments. The primary objective of the EPMP implementation is to determine the progress of activities under this NOFO and indicate how they relate to the desired outcomes. The results will be used for program improvement, accountability and reporting, and for sharing with partners and other stakeholders. The EPMP framework describes the desired activities, outcomes and performance measures and how CDC will work with the recipient to support achievement of these.

Performance Measures Activities

Process measures

Potential Data Sources*

Activities

1. Lead development of and support the scientific innovation and evaluation needed to guide development of global immunization policies, standards and tools for vaccine management and logistics and social mobilization and vaccine demand creation

· Evidence of how existing policies, guidelines, standards and tools are being used by, and/or meet needs of countries

· Gaps in policies, guidelines, standards and tools identified, and solutions developed to address the gaps

· Publication of scientific evidence, policies, standards and tools for vaccine management, logistics, social mobilization and vaccine demand creation

2. Provide vaccines and logistical and technical support to implement delivery of safe and effective vaccines

· Number of managers and vaccinators trained

· Number of countries with sufficient and uninterrupted supply of appropriate vaccines

· Number of vaccines not available to meet shipment plan

· Percentage of doses of vaccine used worldwide that are of assured quality

· Number of doses of vaccines of assured quality used in a country/total doses of vaccines used in national immunization programme

· The recipient Supply Division (SD) annual shipment plans through

MOU

· The recipient Supply Division reports

· JRF

3. Generate economic and financial evidence to support sustainable immunization financing, program planning, budgeting and decision making

· Number of Member States committed to immunization as a priority: domestic expenditures for immunization per person targeted

· Vaccine Price Indicator: Number of countries sharing price information through the V3P platform by WHO region

· Vaccine Price Indicator: Annual average or unit vaccine prices

· Number of vaccine delivery technologies (devices and equipment) that have received who prequalification

· GVAP Monitoring Indicators

Outcomes Performance Measures Potential Data

Process Measures Outcome Measures Sources*

Short Term Outcomes

1. Increased polio vaccine delivery to endemic countries

· Procured and delivered vaccine and safe injection supplies

· Updated microplans that identify inaccessible areas and their needs;

· Implement measures to improve vaccine access (e.g. improved cold chain and mobile outreach strategies)

· Improved management of vaccine stocks

· Increased access to vaccines through routine immunization and/or SIAs

· WUENIC, JRF

· Administrative immunization coverage;

· Rapid convenience assessments;

· Post-campaign coverage survey

2. Increased capacity to generate, interpret and use surveillance data

· Evidence of using program data (VPD surveillance, coverage) to inform program planning

· Number or % of low-and middle income countries with functioning real-time data (e.g. dashboard) for

a) VPD surveillance and

b) routine immunization coverage data

· WUENIC estimates

3. Increased use of evidence-based immunization policy and program decision making

· Documentation of how evidence-based policies, guidelines, standards and tools are being used by, and/or meet needs of countries

4. Improved social mobilization, advocacy and

· Number of communication campaigns that increased acceptance of communication vaccination campaigns and address safety concerns for polio program staff

5. Increase in systematic efforts to assess demand barriers for routine immunization and tailor community engagement strategies to local conditions and appropriate platforms

· Percentage of countries that have assessed (or measured) the level of confidence in vaccination at subnational level

· Percentage of un- and under-vaccinated in whom lack of confidence was a factor that influenced their decision

· JRF

6. Increase in country capacity for vaccine safety assessment and response

· “# low or middle income countries that received training and/or demonstrated capacity for vaccine safety assessment and response

· JRF

7. Improved ability to monitor sub-national program performance and identification of inequities

· Updated microplans that address inequitable access to routine services

· Increased targeted outreach to hard-to-reach communities delivering standardized information and services

· Increased routine immunization coverage in hard-to-reach communities

· GVAP Monitoring Indicators

8. Measurable increase in country capacity to support vaccine introduction

· Number of low- and middle income countries which have applied for/identified funding for introduction of new vaccines in the reporting period

· Number of low-income and middle income countries that have introduced one or more new or underutilized vaccines

· World Bank, JRF

9. Improved technical and management capacity,

· Workforce performance outcomes and competencies identified

· Specific performance outcomes and learning objectives met

· #/% number/percent

· Documents from completion of plans, reports and M&E processes-performance and accountability of the immunization workforce

· Workforce development and training needs and gaps analyzed;

· Strategy and intervention designed

· Intervention plan, processes, training curricula and performance support developed;

· Workforce development intervention and monitoring evaluation plan developed (e.g.

Strategy implemented and evaluation completed)

· Supervision plans incorporate workforce, performance support and development elements of staff receiving intervention and performing adequately based on identified workforce performance priorities by demographics (i.e.

number of staff trained, local, sub-national, national level staff, etc.);

· Analysis of pre-and post-intervention performance practices and outcomes

· Knowledge and skill assessments and observations during and after workforce interventions.

· Monthly/quarterly reports

10. Improved quality and increased use of IIS data to monitor, evaluate, and improve immunization programs

· Correlation between % districts with DTP3 coverage ≥ 80% compared to national coverage estimate for

DTP3

· Describe factors affecting accuracy of numerator data globally, and any changes in these.

· Number of low- and middle income countries with functioning real-time data (e.g.

dashboard) for a) VPD surveillance and b) routine immunization coverage data.

· Number of countries with Immunization coverage data assessed as high quality by WHO and the recipient

· JRF

· WUENIC Grade of Confidence

11. Improved knowledge and use of economic and financing information among immunization

· Expenditure and financing indicators by country groupings (regions, income level, coverage, other country

· Presence of an independent technical advisory group that meets defined criteria of functionality as described in the

· JRF

· FSP immunization financing database

· cMYP data stakeholders classifications) WHO/the recipient JRF

· Increasing trend in number of countries with functional NITAGs

12. Increased number of countries with Polio transition strategies officially documented

· Number of planned transition strategies that have implemented as planned during the reporting period

· Number/% of member states with completed a) transition plans and b) mapping of polio resources

Intermediate Term Outcomes

1. All regions will have rubella elimination goals

· Number of regions with goals to declare interruption of endemic rubella virus transmission for a period of > 12 months in 100% of countries, without occurrence of CRS cases associated with endemic transmission in the presence of high quality surveillance

· Each region has a verification commission which annually reviews the status of all countries

2. Improved and maintained vaccine coverage and equity

· Updated microplans that identify improved vaccine coverage and equity in urban, hard to reach, and disenfranchised communities;

· Implemented measures to improve vaccine coverage and equity

· Increased access to vaccines through routine immunization

· Reduction in coverage gaps between wealth quintiles and other appropriate equity indicator(s)

· Improved vaccine coverage in urban, hard to reach, and disenfranchised communities

· Number of districts with 80% or greater coverage with three doses of diphtheria-tetanus-pertussis

· Household survey

· Administrative immunization coverage;

· Post-campaign coverage survey and/or SIAs containing vaccine

3. Polio assets and resources transitioned to other immunization activities

· Number of member states that have transitioned identified polio resources to support other VPD-related activities

· Number of countries that routine provide at least one dose of IPV into their routine EPI schedule

4. Increase in demand for both routine and campaign immunization services and decrease in vaccine hesitancy

· Percentage of countries that have assessed (or measured) the level of confidence in vaccination at subnational level

· Percentage of un- and under-vaccinated in whom lack of confidence was a factor that influenced their decision

· JRF

Long-Term Outcomes

1. All regions reach their hepatitis B control goals

· Hepatitis B surface antigen of less than 1% among children aged 5 years

· Serological surveys among vaccinated cohorts of children

2. Increased vaccine equity and coverage

· Updated microplans that identify improved vaccine coverage and equity in urban, hard to reach, and disenfranchised communities;

· Implement measures to improve vaccine coverage and equity

· Number of countries sustained coverage of diphtheria-tetanus-pertussis-containing vaccines 90% or greater for three or more years

· Improved vaccine coverage in urban, hard to reach, and disenfranchised communities

· Reduction in coverage gaps between wealth quintiles and other appropriate equity

· WUENIC

· Administrative immunization coverage;

· Post-campaign coverage survey

· Household Surveys indicator(s)

3. Improved and sustained support for vaccine delivery

· Updated microplans that identify improved vaccine access for hard to reach areas (e.g.

mobile outreach strategies)

· Improved vaccine delivery infrastructure (i.e. cold chain and vaccine stock in health facilities)

· Increased access to vaccines through routine immunization and/or SIAs

· Administrative immunization coverage;

· Cold chain assessments;

· Post-campaign coverage survey

*Sources of data for performance measures may include existing data sources, such as administrative immunization coverage data provided through existing channels like the WHO/UNICEF Joint Reporting Form, or may include new data sources, such as quarterly update reports to CDC. Relevant data sources from the sub-national, national, regional or global level should be specified, as appropriate, in the Evaluation and Performance Measurement Plan (EPMP). As such, reporting frequency of measures will vary. Grantees should specify reporting frequency as quarterly or annually in the EPMP.

ii. Applicant Evaluation and Performance Measurement Plan Applicants must provide an evaluation and performance measurement plan that demonstrates how the recipient will fulfill the requirements described in the CDC Evaluation and Performance Measurement and Project Description sections of this NOFO. At a minimum, the plan must describe:

How applicant will collect the performance measures, respond to the evaluation questions, and use evaluation findings for continuous program quality improvement.

How key program partners will participate in the evaluation and performance measurement planning processes.

Available data sources, feasibility of collecting appropriate evaluation and performance data, and other relevant data information (e.g., performance measures proposed by the applicant)

Plans for updating the Data Management Plan (DMP), if applicable, for accuracy throughout the lifecycle of the project. The DMP should provide a description of the data that will be produced using these NOFO funds; access to data; data standards ensuring released data have documentation describing methods of collection, what the data represent, and data limitations; and archival and long-term data preservation plans.

For more information about CDC’s policy on the DMP, see https://www.cdc.gov/grants/additionalrequirements/ar-25.html.

Where the applicant chooses to, or is expected to, take on specific evaluation studies, they should be directed to:

Describe the type of evaluations (i.e., process, outcome, or both).

Describe key evaluation questions to be addressed by these evaluations.

Describe other information (e.g., measures, data sources).

Recipients will be required to submit a more detailed Evaluation and Performance Measurement plan, including a DMP, within the first 6 months of award, as described in the Reporting Section of this NOFO.

c. Organizational Capacity of Recipients to Implement the Approach The eligible applicant must clearly describe their demonstrated experience and collaboration in the following areas:

Demonstrated experience of collaboration in public health programs with priority country national governments;

Demonstrated experience of collaboration with multiple polio eradication and measles elimination partners including BMGF, USAID, WHO, Rotary, GAVI and others;

Demonstrated accomplishments in addressing and implementing public health program needs in complex settings;

Demonstrated capacity to mobilize sufficient culturally competent personnel to achieve outcomes;

Ability to manage financial reporting, budget management and administration, personnel, as well as management of grants and contracts

d. Work Plan Period of Performance Outcome:

[from Outcomes section and/or logic model]

Outcome Measure:

[from Evaluation and Performance Measurement section]

Strategies and Activities

Process Measure [from Evaluation and Performance Measurement section]

Responsible Position / Party

Completion Date

1.

2.

https://www.cdc.gov/grants/additionalrequirements/ar-25.html

3.

4.

5.

6.

e. CDC Monitoring and Accountability Approach Monitoring activities include routine and ongoing communication between CDC and recipients, site visits, and recipient reporting (including work plans, performance, and financial reporting).

Consistent with applicable grants regulations and policies, CDC expects the following to be included in post-award monitoring for grants and cooperative agreements:

Tracking recipient progress in achieving the desired outcomes.

Ensuring the adequacy of recipient systems that underlie and generate data reports.

Creating an environment that fosters integrity in program performance and results.

Monitoring may also include the following activities deemed necessary to monitor the award:

Ensuring that work plans are feasible based on the budget and consistent with the intent of the award.

Ensuring that recipients are performing at a sufficient level to achieve outcomes within stated timeframes.

Working with recipients on adjusting the work plan based on achievement of outcomes, evaluation results and changing budgets.

Monitoring performance measures (both programmatic and financial) to assure satisfactory performance levels.

Monitoring and reporting activities that assist grants management staff (e.g., grants management officers and specialists, and project officers) in the identification, notification, and management of high-risk recipients.

CDC Grant Monitoring Activities Throughout the five-year NOFO period, CDC will engage in the following monitoring activities:

o Monthly calls to review program progress, determine needs for technical assistance, and review administrative actions o Annual site visits to review programmatic progress and to plan for the following budget period; site visits will include a review of recipient program and financial reporting systems o Technical review of annual workplans and budgets, with written feedback provided to the recipient o Review of financial and programmatic reports submitted by the recipient

CDC Approaches for NOFO Evaluations:

Throughout the five-year NOFO period, CDC will partner with the recipient to conduct program monitoring and evaluation of activities as needed. This includes:

Conducting process and outcome evaluations of the funded activities.

o Process Evaluation: Process evaluation will assess the extent to which the agreed NOFO activities have been implemented as planned. Limitations, barriers, and key success factors of the implementation will be explored. It is expected that this evaluation will be conducted during Years 2-3.

o Outcome Evaluation: Outcome evaluation will be conducted to determine whether the funded activities are leading to the expected outcomes. It is expected that this evaluation will be conducted during Years 3-4.

Finalizing the evaluation protocols and plan for implementation at the designated timeframe; further, a system for collecting data over time to answer evaluation questions should be established during program implementation.

Ensuring all evaluations are consistent with established frameworks and program specific requirements. Submission of Non-research Determination (NRD) CDC-ADS for ethical clearance is required. CDC will assist with the submission process.

Reporting the evaluation findings to relevant stakeholders and making these publically available in order to enhance the utilization of the findings to improve program effectiveness, and continued program improvement.

CDC Roles & Responsibilities:

CDC will provide technical assistance to the recipient to ensure the following practices are consistent with the established evaluation standards and are integrated with all evaluation activities:

Engage stakeholders Clearly state evaluation questions, purpose, and objectives Use appropriate evaluation design, methods, and analytical techniques Address ethical considerations and assurances Identify resources and articulate budget Construct data collection and management plans Ensure appropriate evaluator qualifications and evaluation independence Monitor the planning and implementation of an evaluation Produce quality evaluation reports Disseminate results Use findings for program improvement and sustainability

f. CDC Program Support to Recipients (THIS SECTION APPLIES ONLY TO

COOPERATIVE AGREEMENTS)

CDC Staff will be substantially involved in the program activities outlined in this NOFO to include

Providing technical assistance to the recipient in support of the activities implemented under this agreement.

Collaborating with the recipient to provide programmatic support to national governments for planning, implementing, and evaluating polio eradication, measles mortality reduction, and other globally agreed VPD control activities.

Assisting in providing technical training, support, and consultation to expert staff hired by the recipient to assist in the polio eradication, measles mortality reduction and GVAP strategies.

Providing expertise for the maintenance and development of surveillance structures, including assessment, strategy design, evaluation and assistance in priority countries.

Collaborating with and providing technical assistance to the recipient to determine appropriate strategies to address other mutually agreed global health priorities that may be addressed through this CDC-the recipient agreement, if and when required.

B. Award Information

1. Funding Instrument Type: Cooperative Agreement CDC's substantial involvement in this program appears in the CDC Program Support to Recipients Section.

2. Award Mechanism: U2G

3. Fiscal Year: 2018

4. Approximate Total Fiscal Year Funding: $36,000,000

5. Approximate Period of Performance Funding: $0

This amount is subject to the availability of funds.

There is not project period ceiling; however, the estimated amount is $180,000,000

Estimated Total Funding: $180,000,000

6. Approximate Period of Performance Length: 5 year(s)

7. Expected Number of Awards: 1

8. Approximate Average Award: $36,000,000 Per Budget Period

9. Award Ceiling: $0 Per Budget Period

This amount is subject to the availability of funds.

There is no award ceiling; however, the estimated amount is $36,000,000

10. Award Floor: $0 Per Budget Period

11. Estimated Award Date: 07/01/2018

12. Budget Period Length: 12 month(s)

Throughout the project period, CDC will continue the award based on the availability of funds, the evidence of satisfactory progress by the recipient (as documented in required reports), and the determination that continued funding is in the best interest of the federal government. The total number of years for which federal support has been approved (project period) will be shown in the “Notice of Award.” This information does not constitute a commitment by the federal government to fund the entire period. The total period of performance comprises the initial competitive segment and any subsequent non-competitive continuation award(s).

13. Direct Assistance Direct Assistance (DA) is not available through this FOA.

C. Eligibility Information

1. Eligible Applicants Eligibility Category: Others (see text field entitled "Additional

Information on Eligibility" for clarification)

Additional Eligibility Category:

2. Additional Information on Eligibility Single Eligibility - United Nations Children’s Fund (UNICEF) Eligibility is limited to UNICEF, 3 United Nations Plaza, New York, NY 10017-4414.

3. Justification for Less than Maximum Competition The recipient should be considered as the single source for this funding opportunity because:

1) The recipient is a lead agency for the Global Polio Eradication Initiative, the Global Measles and Rubella Initiative, and the Global Vaccine Action Plan (GVAP) along with CDC, WHO and others. The recipient's role in these partnerships is unique as the world's largest purchaser of childhood vaccines and has the primary responsibility for providing countries with access to high quality, affordable vaccines. The recipient is the recognized global leader for vaccine procurement with an established worldwide vaccine procurement and distribution network upon which national governments rely for vaccine supplies.

2) The recipient performs a critical role in promoting vaccine security by working with manufacturers to ensure there is a reliable supply of quality affordable vaccines, and with governments to assess their vaccine requirements and harmonize these requirements to manufacturers.

3) The recipient's has an extensive infrastructure, with an established presence in 193 countries;

and a globally recognized mandate to provide programmatic assistance to governments in the areas of planning, training, social mobilization and communications, cold chain and logistics for immunization campaigns and routine service delivery in the most critical and challenging countries in the world. In its role as the acknowledged global and national lead on social mobilization and community engagement, the recipient is an essential global and in-country partner to CDC, WHO and national governments in designing systems that can diagnose and respond effectively to vaccine hesitance and threats to resilient demand from adverse events and other vaccine related events such as threats from social media and anti-vaccination activists.

4) The recipient and CDC have demonstrated success in this partnership, through cooperative agreements spanning 25 years. During this time, the annual number of wild poliovirus cases has decreased by greater than 99% from 1988 to 2016 and global measles deaths have decreased by 79% from 2000 to 2014. This success is primarily attributed to decreased vaccine hesitancy (increased vaccine uptake) in high quality campaigns and supplemental immunization activities (SIAs) designed to close immunity gaps, for which the recipient ensures sufficient, secure vaccine supplies and training of culturally-competent, vaccine demand promoting, community-based vaccinators. Critical to this success, the recipient has established a vaccine demand promotion agenda that has yielded a number of specific achievements and ongoing activities including workshops on collection and analysis of social data to inform social mobilization and community engagement in 22 priority countries.

The impact of disapproval would be significant disruption in the procurement, distribution and demand of vaccines worldwide and in the programming and projects agreed upon by the CDC, the GPEI, GMR&I and GVAP as critical for control and prevention of vaccine-preventable diseases worldwide putting millions of children under the age of 5 years at risk for multiple VPDs including polio and measles. As just one example, routine and supplementary immunization activities with measles vaccine are expected to avert 13.4 million deaths between 2011 and 2020. In addition, without the ability to procure and distribute vaccines worldwide, the GPEI will fail to meet its goal of global polio eradication by 2020. The Polio Monitoring Board estimates that delaying eradication would result in an increase in virus circulation and exportation to neighboring countries and a global reintroduction resulting in as many as 200,000 new cases each year within a decade. Delaying polio eradication is estimated to cost $800 million USD annually per year of delay.

As this is a new NOFO, no same or similar deviation has been previously requested for this project. However, the previous NOFO, CDC-RFA-GH13-1302 was approved as a single source NOFO. Also, a single source justification was approved August 2016 for an Expansion Supplement.

4. Cost Sharing or Matching Cost Sharing / Matching Requirement: No Cost sharing or matching funds are not required for this program. Although no statutory matching requirement for this NOFO exists, leveraging other resources and related ongoing efforts to promote sustainability is strongly encouraged.

5. Maintenance of Effort Maintenance of effort is not required.

D. Application and Submission Information

1. Required Registrations An organization must be registered at the three following locations before it can submit an application for funding at www.grants.gov.

a. Data Universal Numbering System:

All applicant organizations must obtain a Data Universal Numbering System (DUNS) number.

A DUNS number is a unique nine-digit identification number provided by Dun & Bradstreet (D&B). It will be used as the Universal Identifier when applying for federal awards or cooperative agreements.

The applicant organization may request a DUNS number by telephone at 1-866-705-5711 (toll free) or internet at http:// fedgov.dnb. com/ webform/ displayHomePage.do. The DUNS number will be provided at no charge.

If funds are awarded to an applicant organization that includes sub-recipients, those sub-recipients must provide their DUNS numbers before accepting any funds.

b. System for Award Management (SAM):

The SAM is the primary registrant database for the federal government and the repository into which an entity must submit information required to conduct business as a recipient. All applicant organizations must register with SAM, and will be assigned a SAM number. All information relevant to the SAM number must be current at all times during which the applicant has an application under consideration for funding by CDC. If an award is made, the SAM information must be maintained until a final financial report is submitted or the final payment is received, whichever is later. The SAM registration process can require 10 or more business days, and registration must be renewed annually. Additional information about registration procedures may be found at www.SAM.gov.

c. Grants.gov:

The first step in submitting an application online is registering your organization at www.grants.gov, the official HHS E-grant Web site. Registration information is located at the “Get Registered” option at www.grants.gov.

All applicant organizations must register at www.grants.gov. The one-time registration process usually takes not more than five days to complete. Applicants should start the registration process as early as possible.

Step System Requirements Duration Follow Up 1 Data

Universal Number System

(DUNS)

1. Click on http:// fedgov.dnb.com/ webform

2. Select Begin DUNS search/request process

3. Select your country or territory and follow the instructions to obtain your DUNS 9-digit #

1-2 Business Days

To confirm that you have been issued a new DUNS number check online at (http:// fedgov.dnb.com/ webform) or call https://www.grants.gov/ http://fedgov.dnb.com/webform/displayHomePage.do https://www.sam.gov/portal/public/SAM/ https://grants.gov/ https://www.grants.gov/ https://www.grants.gov/ https://www.grants.gov/ http://fedgov.dnb.com/webform http://fedgov.dnb.com/webform http://fedgov.dnb.com/webform http://fedgov.dnb.com/webform http://fedgov.dnb.com/webform

4. Request appropriate staff member(s) to obtain…